Does any glimpse, any shadow of the consciousness once known as "Terri Schiavo" still exist? That question is hard to answer, though most doctors who have examined her say no. The problem for me, though, is that even if we could be certain one way or the other, we still wouldn't be sure what to do. It's possible that if there is a glimmer of Terri Schiavo left, the right thing for her parents to do is to let her die. And it's possible that if she's gone forever, the most humane thing for her husband to do is to let her continue to lie in that hospice bed.
The politics of the Schiavo case are much easier to parse. Republicans marshaled Congress back into session on a Sunday night to pass a bill giving jurisdiction to the federal courts; President Bush, hustling back from Texas, got up in the middle of the night to sign the measure into law.
(Carlos Barria -- Reuters)
I'll accept the idea that some GOP legislators were acting out of sincere belief, but the whole thing smacks of an opportunistic ploy to gratify the party's pro-life base. Senate Majority Leader (and transplant surgeon) Bill Frist's "diagnosis" of Schiavo's condition, based on viewing a brief, four-year-old videotape, was a disgrace to the medical profession. Michael Schiavo, the husband who has fought for seven years to let his wife die according to her wishes, called House Majority Leader Tom DeLay a "little slithering snake" and asked whether any members of Congress even knew what color Terri's eyes are. What color, Sen. Frist? Rep. DeLay?
That's easy; the rest is hard.
The precise nature of consciousness continues to elude both science and philosophy. Sir Roger Penrose, the eminent British mathematician and physicist who made important discoveries about black holes and the geometry of space-time, spent years working on the idea that consciousness somehow derives from submicroscopic quantum-mechanical processes. He has failed to convince most of his colleagues. Theologians would offer a different explanation for the spark that somehow makes a grayish blob of tissue self-aware. The answer is either unknown -- and perhaps unknowable -- or a matter of faith.
Assume that both Terri Schiavo's husband and her family are acting with her wishes and best interests in mind. Now, let's say that the family is right, and some fraction of the woman they knew and loved is still present. The family says this means she should be kept alive. But does it? Even the family would have to agree that not much of Terri still exists, maybe just enough to recognize family members -- and enough to be aware of her situation. According to her husband, her wish was not to be kept alive artificially. If she is indeed aware of her condition, and never wanted to be kept going this way, then continued feeding may be not succor but prolonged torture.
Of course, it could be possible that she had changed her mind and decided she wanted to continue living. But we have no way of knowing, because she can't tell us. It is possible that by keeping her alive, the family that loves Terri Schiavo is condemning her to years of unspeakable agony, without even the ability to scream.
Almost all of the doctors who have conducted a real examination believe it's impossible that she's in agony. They're convinced that she is in a "persistent vegetative state," which means she is gone. They say there's nothing behind that smile -- no warmth, no delight, no recognition, nothing except the reflexive firing of autonomic neurons.
Assume that they, and the husband, are right. In that case, there is no "Terri Schiavo" inside that shell. Michael Schiavo might want to follow his wife's wishes, but she doesn't realize that she's been fed through a tube all these years. She doesn't realize anything. If her husband is sure she's gone, then her wishes become just one of many factors he should weigh.
Another factor for him to consider is that her family feels so passionately about keeping the empty shell of Terri Schiavo alive. If doing so causes no harm to his wife while providing great comfort and joy to the family, why not allow them to take over her care?
Neither the husband nor the family has an absolute solution. Only Terri Schiavo does, and she can't tell us what to do.